Evidence map›Paper›PMID 42270801›Full record

ArticleCommunications medicine2026

Longitudinal associations of suffering with subsequent multidimensional well-being in the Global Flourishing Study.

Richard G Cowden, R Noah Padgett, Chris Felton, Renae Wilkinson, Lucía Macchia, Zhuo Job Chen, Dorota Weziak-Bialowolska, Stephanie M Koning, Craig Gundersen, Byron R Johnson and 1 more

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Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Richard G CowdenHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA. rcowden@fas.harvard.edu.ORCID http://orcid.org/0000-0002-9027-4253
R Noah PadgettHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.ORCID http://orcid.org/0000-0002-9114-3896
Chris FeltonHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
Renae WilkinsonHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.ORCID http://orcid.org/0000-0002-5104-5511
Lucía MacchiaSchool of Health and Medical Sciences, City St George's, University of London, London, UK.
Zhuo Job ChenSchool of Nursing, University of North Carolina at Charlotte, Charlotte, NC, USA.ORCID http://orcid.org/0000-0003-0839-1627
Dorota Weziak-BialowolskaHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.ORCID http://orcid.org/0000-0003-2711-2283
Stephanie M KoningDepartment of Health Behavior, Policy, and Administrative Sciences, School of Public Health, University of Nevada, Reno, NV, USA.
Craig GundersenDepartment of Economics, Baylor University, Waco, TX, USA.
Byron R JohnsonInstitute for Studies of Religion, Baylor University, Waco, TX, USA.
Tyler J VanderWeeleHuman Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.ORCID http://orcid.org/0000-0002-6112-0239

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuffering is a distressing personal experience that may have important implications for well-being, but little is known about its population-level links with well-being. We use longitudinal survey data from the multinational Global Flourishing Study to examine prospective associations between suffering and multidimensional well-being assessed approximately 1 year later.

methodsWe analyzed two waves of nationally representative data from adults living in 23 countries and territories (N = 207,919). Following the analytic template for outcome-wide designs, we estimated a series of country-specific weighted regression analyses where each Wave 2 outcome was regressed on Wave 1 suffering (controlling for Wave 1 demographic and retrospectively recalled childhood variables). Random effects meta-analyses were used to pool country-specific estimates of associations for the 56 main outcomes encompassing psychological, social, physical, volitional, and material dimensions of well-being.

resultsWe find some evidence of association between suffering and worse well-being for both composite indicators and most specific well-being indicators when country-specific estimates are pooled meta-analytically. Somewhat stronger and more consistent associations are observed for some domains (e.g., psychological well-being) than others (e.g., social participation). Pooled cross-national estimates of association generally attenuate after applying a more conservative analytic approach in which additional adjustment is made for principal components extracted from the Wave 1 outcomes. Country-specific estimates show some cross-national variation.

conclusionsOur findings suggest that suffering is associated with worse well-being across a wide range of outcomes in diverse national contexts. Suffering may be an important consideration in research, interventions, and policies aimed at supporting population well-being.

Identifiers

PMID42270801

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.